Abstract
A lot of different flowers make a bouquet. ∼ Islamic Proverb
Equity, diversity, and inclusion (EDI) in medicine are intrinsically linked to health equity, and accordingly, medical faculties and many specialties have begun to address EDI concerns. Changes in Canadian Radiology, however, have lagged, and it has only been in the last year that Canadian academic radiology departments have considered EDI a priority. The University of British Columbia (UBC) Department of Radiology was among the first Canadian academic radiology departments to create formal EDI initiatives. Here, we share our experience in hopes that it will guide and inspire radiology departments wishing or mandated to incorporate EDI in departmental structure and operations. Our experience confirms that with leadership support, much can be achieved toward improving EDI in radiology.
Many studies confirm a gender gap in Canadian radiology. 1 Although women 1 represent over half Canadian medical students, women remain underrepresented in radiology. 2 In 2016, UBC did not match women to radiology, resulting in no women in the 2020 UBC Radiology graduating class. Women continue to make up only 20% of UBC Radiology residents. The gender gap in Canadian academic ranks and leadership has also been established. 3 There is no Canadian radiology data in regards to other underrepresented minorities (URM). 1
First proposed in 2017, the UBC Radiology EDI Committee (UBCREDIC) was formed in January 2021. UBCREDIC Co-Chairs were selected by the Department Head based on demonstrated EDI leadership and academic track record in EDI. UBCREDIC Co-Chairs and Department Head created terms of reference in alignment with the Canadian Medical Association Policy on Equity and Diversity in Medicine, the Indigenous Strategic Plan, Building Inclusive UBC: An Inclusion Action Plan, and UBC’s strategic priorities around Indigeneity and EDI. UBCREDIC’s purpose is to “promote diversity in recruitment, retention, promotion, and recognition of faculty, residents, and medical students within the UBC Department of Radiology, and ensure an inclusive environment for all members of the department whilst championing equity and providing the same access and opportunities for all.” While this environment is a shared responsibility of all departmental members and requires their ongoing commitment, UBCREDIC coordinates these departmental efforts.
There was an open call for UBCREDIC faculty, trainees, and administrative members. Current membership represents a range of genders, URMs, career stages, subspecialties, and sites across the province. The first priority identified by members was EDI Grand Rounds (GR) and hands on EDI workshops. The first EDI GR and academic half day (AHD) were held in Fall 2021. International EDI experts invited to speak also participated in a panel discussion. GR and AHD were made public, and the recording is available online. A series of EDI GR by local and international EDI experts was launched in April 2022, named after a pioneering Canadian radiology woman.
Wellness and EDI Vice Chair positions were created within UBC Radiology in 2021. The Co-Chairs of the EDI committee were appointed Co-Vice Chairs EDI (CVCEDI), and were asked to submit an EDI report for the 2021 Radiology Department Internal Review (IR). The IR identified many EDI issues, and the CVCEDI assisted the working group (WG) that responded to IR recommendations. Since the IR, there has been considerable support for UBC Radiology EDI initiatives. CVCEDI recommendations for Vice Chair and Awards selection processes have been implemented. CVCEDI recommendations to improve the CaRMS selection committee diversity and transparency were addressed, leading to deliberate change in selection committee structure and process. The EDI Report is now a standing agenda item at Resident Planning Committee meetings.
The CVCEDI were invited to present at the 2021 and 2022 UBC Radiology annual continuing medical education (CME) event the Vancouver Imaging Review. One of the CVCEDI updated the “Women’s Imaging” session to “Breast, Gynecological and Obstetrical Imaging.” This was the first gender inclusive change adopted by any Canadian academic radiology CME event. 4 An event organized by the CVCEDI and sponsored by Vancouver Imaging for International Women’s day 2022 included the female URM Presidents of Doctors of BC and BC Radiological Society.
UBCREDIC member profiles are featured in addition to EDI resources on the newly created EDI tab on the UBC Radiology website. Increasing visibility of diverse faculty creates a stronger and more inclusive environment for existing and prospective department members. A wider group of medical students and potential new faculty will see themselves represented and are more likely to apply to UBC, thereby strengthening the department. Increased visibility also helps UBCREDIC members, many of whom are women and URM, feel like their work is valued.
Ongoing UBCREDIC work includes a diversity statement and survey. Results from local data will help direct future EDI efforts. New departmental awards including EDI, mentorship, and administration were created for further recognition of EDI work. A bias training module was shared with UBC Radiology faculty members, mandatory for all UBC Radiology committee members.
EDI work outside UBCREDIC is being done by many department members. UBCREDIC members are represented in the Awards Selection Committee and in the Departmental Strategic Plan WG. A mentorship initiative was launched and many members are involved in EDI activities through Canadian Radiology Women, the Canadian Association of Radiologists EDI WG and committees, as well as through peer reviewed EDI research. The CVCEDI have been invited to speak on EDI internationally. This local expertise has helped shape and augment UBC Radiology EDI initiatives.
UBC Radiology’s EDI accomplishments may be encouraging, but we have much work to do. There is no end goal for EDI. EDI metrics cannot be ticked off a list. Ongoing education, research, and intentional change will be required to create and maintain a diverse radiology workforce. UBC has demonstrated that leadership support of EDI initiatives can result in positive change. We encourage all radiology leaders to commit to EDI. There is great opportunity in Canadian radiology to strengthen our teams and improve patient care.
ORCID iDs
Charlotte J. Yong-Hing https://orcid.org/0000-0001-5014-1651
Michael N. Patlas https://orcid.org/0000-0001-9304-6355
Faisal Khosa https://orcid.org/0000-0001-5681-7683